Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Evaluation of Sentinel Lymph Nodes in Complex Atypical Endometrial Hyperplasia

Hala Al Kallas
,
Pamela Cooper
,
Shruti Varma
,
Jenna Peplinski
,
Yan Hong Kuo
,
Brianna Miller
,
Noelle Aikman
,
Mark Eliot Borowsky
,
Ashley Haggerty
,
Karim ElSahwi
* ORCID logo
Version 1 : Received: 18 April 2024 / Approved: 19 April 2024 / Online: 19 April 2024 (15:25:22 CEST)

How to cite: Al Kallas, H.; Cooper, P.; Varma, S.; Peplinski, J.; Kuo, Y.H.; Miller, B.; Aikman, N.; Borowsky, M.E.; Haggerty, A.; ElSahwi, K. Evaluation of Sentinel Lymph Nodes in Complex Atypical Endometrial Hyperplasia. Preprints 2024, 2024041345. https://doi.org/10.20944/preprints202404.1345.v1 Al Kallas, H.; Cooper, P.; Varma, S.; Peplinski, J.; Kuo, Y.H.; Miller, B.; Aikman, N.; Borowsky, M.E.; Haggerty, A.; ElSahwi, K. Evaluation of Sentinel Lymph Nodes in Complex Atypical Endometrial Hyperplasia. Preprints 2024, 2024041345. https://doi.org/10.20944/preprints202404.1345.v1

Abstract

Complex atypical endometrial hyperplasia (CAH) carries a high probability of cancer. Intraoperative evaluation of endometrial cancer in cases of CAH has not been reliable. The safety and sensitivity of sentinel lymph node (SLN) sampling has been validated. We aim to evaluate the efficacy and safety of SLN sampling in CAH managed by the da Vinci robotic platform. A total of 113 patients with a preoperative diagnosis of CAH were included in this retrospective cohort study. All underwent a robot assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with 69 patients undergoing SLN sampling. Statistical analysis calculated the probability of cancer, SLN map rate, and surgical complications. Predictors of cancer were evaluated. Forty-seven percent of the entire cohort were diagnosed with endometrial cancer. Median age was 63 years in the SLN cohort (N = 69) and 61 in the No SLN cohort (N = 44) (p= 0.363).  Median BMI was 34 Kg/m2 in the SLN cohort and 40 in the No SLN cohort (p= 0.004). Bilateral SLN map was 92.8% and unilateral SLN map rate was 7.2%. There were no grade 3-4 complications in the SLN cohort, and 4 grade 3-4 complications in the No SLN group (p=0.021). A preoperative diagnosis of CAH bordering on or cannot rule out cancer was the only predictor of cancer.

Keywords

Complex atypical hyperplasia; robotic surgery; sentinel lymph node; indocyanine green; endometrial cance

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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